Abstract

Purpose

To evaluate the efficacy of low-dose radiotherapy in painful gonarthritis.

Methods

We assessed the medical records of 1037 patients with painful gonarthritis who had
undergone low-dose radiotherapy between 1981 and 2008. The subjective patient perception
of the response to irradiation as graded immediately or up to two months after the
completion of a radiotherapy series was evaluated and correlated with age, gender,
radiological grading and the duration of symptoms before radiotherapy. Moreover, we
performed a mail survey to obtain additional long-term follow-up information and received
one hundred and six evaluable questionnaires.

Results

We assessed 1659 series of radiotherapy in 1037 patients. In 79.3% of the cases the
patients experienced a slight, marked or complete pain relief immediately or up to
two months after the completion of radiotherapy. Gender, age and the duration of pain
before radiotherapy did not have a significant influence on the response to irradiation.
In contrast, severe signs of osteoarthritis were associated with more effective pain
relief. In more than 50% of the patients who reported a positive response to irradiation
a sustained period of symptomatic improvement was observed.

Conclusions

Our results confirm that low-dose radiotherapy is an effective treatment for painful
osteoarthritis of the knee. In contrast to an earlier retrospective study, severe
signs of osteoarthritis constituted a positive prognostic factor for the response
to irradiation. A randomized trial is urgently required to compare radiotherapy with
other treatment modalities.